Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | 012867 | NY |
Y | 213ER0200X | Radiology | 012867 | NY |
NPI | 1437673308 |
---|---|
Provider Name | Christopher Lee Smoley |
First Address | Hamburg, NY 14075-4657 |
Second Address | Buffalo, NY 14201-1032 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2017 |
Last Update Date | 01/08/2017 |